Prevalence of Pulmonary Tuberculosis in HIV-Infected Individuals

Abstract

Background: Tuberculosis (TB) is a significant cause of mortality among people living with HIV (PLWH), in Nepal. HIV increases the risk of progression from latent to active TB, increasing mortality. Despite established TB control programs, there is a significant lack of recent data measuring the tuberculosis burden among PLWH specially within the Western region of Nepal. This study was conducted to assess the prevalence of pulmonary tuberculosis among HIV-positive patients attending a tertiary care centre in Gandaki Province, Nepal.
Methods: A hospital-based cross-sectional study was conducted at Western Regional Hospital, Pokhara Academy of Health Sciences, from August 2025 to January 2026. First, HIV-positive patients attending the ART clinic were screened, and those aged ?18 years without prior tuberculosis were included. Next, participants were recruited using convenience sampling. After obtaining informed consent, sociodemographic and clinical data were collected through a structured questionnaire and medical record review. Subsequently, CD4 counts were measured using the PIMA CD4 analyser, and sputum samples were examined using Ziehl–Neelsen staining for acid-fast bacilli. Finally, data were analysed using SPSS version 22, with p < 0.05 considered statistically significant.
Results: Prevalence of pulmonary TB was found to be 5.1% among 137 participants. TB co-infection was found to be higher among males and in the 20-29 years and >70 years age groups. TB was more common among those with CD4 counts <200 cells/µL, but was not statistically significant.
Conclusions: The study found a 5.1% prevalence of pulmonary TB among PLWH in western Nepal and highlights the need for regular TB screening.
Keywords: CD4 count; pulmonary tuberculosis Nepal; TB–HIV co-infection.